James L. Burns - Attorney at Law

 

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WILL PREPARATION QUESTIONNAIRE


Name:
E-Mail Address:
Home Address:
Home Phone:
Type of Employment:
Work Phone:
Marital Status:

Please provide the name(s) of the relative(s) or friend(s) you want to receive any specific item of your real or personal property and describe the real or personal property (i.e., jewelry, stamp collection, etc.) you would like to leave that person:
Recipient Relationship Property
If additional itemizations are required, use the comments section below.

Please provide the name(s) of the relative(s) or friend(s) you want to receive the remainder of your real and personal property:
Recipient Relationship Portion to each
(leave blank if equal)

If additional itemizations are required, use the comments section below.


Please Provide the name(s) of the relative(s) or friend(s) you want to distribute your real and personal property according to your Will and otherwise administer your probate estate (the Executor of your estate):
Primary Relationship
Alternate Relationship

Please provide the name(s) of the relative(s) or friend(s) you want to love and care for your minor children in the event you pass away before your children reach the age of eighteen (18) years old (Guardian(s) of your minor children):
Primary Relationship
Alternate Relationship

Please provide the name(s) of the relative(s) or friend(s) you want to make health care decisions for you in the event you are unable to communicate (i.e., if you were unconscious) such decisions for yourself (Health Care Power of Attorney):
Primary Relationship
Alternate Relationship

Please state whether you would want to be placed or maintained on life-sustaining treatment to prolong your life in the event you are in a terminal condition or in a permanently unconscious state (Living Will Declaration): 

 

 

                                       

James L. Burns
24441 Detroit Road, Suite 300, Westlake, Ohio 44145
Phone:  (440) 575-1100 --  Fax:  (440) 871-5182
Email info@jameslburns.com